TAVI in patient with combined aortic and sub aortic membrane stenosis: a case report
Hesham Tayel, Abdelrahman Elhakim, Mohamed Elsoudi, Amira Nour, Mohammed SaadAbstract
Background
The combination of symptomatic aortic stenosis (AS) and subaortic membrane (SAM) is rare, and the hemodynamic consequences of this combination are challenging to diagnose and manage.
Case presentation
We present the case of a 78-year-old male who presented with symptomatic aortic stenosis and chronic heart failure. On echocardiography, the combination of AS and SAM was diagnosed. Transesophageal echocardiography was performed to confirm the presence and severity of AS and SAM. Based on the patient's clinical profile and the high-risk of surgical repair, a self-expandable-TAVI was performed. Three-month follow-up was uneventful.
In addition, we discuss the assessment and management strategy challenges for SAM in patients with aortic regurgitation or AS.
Conclusion
As trans-catheter valve implantation expands its indications for more complex anatomy and patient´s comorbidity. Self –expandable TAVI-prosthesis under TOE guidance is feasible for the treatment of symptomatic AS and SAM, especially in patients with high surgical risk.